Michigan CRPS and Nerve Damage Attorney

Your wrist fracture healed in eight weeks. The pain did not. It got worse; your hand changes color and temperature, and the skin cannot stand to be touched. Then the MRI and nerve conduction study come back normal, and the insurer’s doctor writes that the testing shows nothing.

Complex regional pain syndrome is a recognized diagnosis with published international criteria, and among the most contested conditions in injury litigation, because it rests on clinical findings rather than one confirmatory test. The literature expects normal imaging here, not evidence against the diagnosis.

Vahdat Weisman Law catastrophic injury attorneys represent Michigan clients with CRPS and serious nerve injuries. Call (734) 469-4994 for a free consultation. No attorney fee unless we recover for you.

How CRPS Is Diagnosed When No Test Shows It

Your doctor works from the Budapest Criteria, the international standard. Four requirements must be met:

A. Continuing pain that is disproportionate to the inciting event. B. At least one reported symptom in three of the four categories below. C. At least one observed sign at the time of evaluation in two of the four categories. D. No other diagnosis better explains the signs and symptoms.

The four categories are sensory (hyperesthesia, allodynia meaning pain from things that should not hurt, hyperalgesia), vasomotor (temperature asymmetry, skin color changes or asymmetry), sudomotor and edema (swelling, sweating changes or asymmetry), and motor and trophic (decreased range of motion, weakness, tremor or dystonia, changes to hair, nail and skin growth).

If you have been told your pain is out of proportion to the injury, that is Criterion A. “Pain disproportionate to the inciting event” is published by the International Association for the Study of Pain as part of the definition of the condition, not a reason to doubt it.

Type I occurs without discrete nerve damage, which is not the same as no nerve abnormality at all. Type II, historically called causalgia, involves a documented peripheral nerve injury, and under the 2021 Valencia consensus, the signs must extend beyond the injured nerve’s territory. Valencia proposed moving CRPS under the chronic primary pain parent category in ICD-11, carried forward through a separate IASP and WHO process, though CRPS holds its own categorization there rather than being synonymous with chronic primary pain. It also added a partly remitted subtype.

A broken bone is the most common trigger, 44 percent in a Dutch cohort and 46 percent in Olmsted County, Minnesota, two population-based studies with female-to-male ratios of 3.4 to 1 and 4 to 1. Surgery, sprains, contusions and crush injuries also precipitate it. Early treatment is the usual recommendation, though the evidence is mixed: a 2024 analysis of 218 patients found both early and persistent CRPS groups improved, with no better post-rehabilitation outcome in the early group.

What a Normal Test Result Actually Proves

No single test settles this either way, which cuts against the insurer as much as you.

Infrared thermography, which measures temperature asymmetry, was reported with sensitivity around 45 percent in an early post-traumatic study and specificity from 50 to 89 percent depending on imaging timing. In a 2025 study applying the Budapest Criteria, thermography was the only corroborating test to show statistically significant diagnostic performance. QSART fared poorly: positive in 80.8 percent of CRPS patients but also in 66.7 percent of patients without CRPS, and limited further by differences between laboratories.

If your bone scan was negative, here is what it is worth. In a study using the Budapest Criteria as the reference standard, three-phase bone scintigraphy had a sensitivity of 40.0 percent, a specificity of 76.5 percent and a positive likelihood ratio of 1.73, and the authors concluded a positive scan had low diagnostic value. A Bayesian meta-analysis found scintigraphy cannot be used to rule CRPS-I in, and that a negative scan makes CRPS-I less likely. A separate meta-analysis found pooled specificity of 0.69 overall, 0.73 in studies using clearly defined criteria. A bone scan neither establishes nor excludes the diagnosis.

Ask when your nerve conduction study and EMG were done: an early study can look normal even where a nerve has been severed. Serial human studies after nerve transection found motor amplitudes falling by about half at three to five days and absent by about day nine, sensory amplitudes by half around day seven and absent by about day eleven, depending on the nerve and its distance from the lesion. Fibrillation potentials and positive sharp waves appear on needle EMG across roughly one to four weeks, nearer a week in muscles immediately distal to the lesion, up to about four weeks in distal muscles. A study run three days after your injury was too early to rule anything out.

What Treatment Can and Cannot Do

A 2023 Cochrane overview of reviews found no high-certainty evidence for any CRPS therapy and called the spinal cord stimulation evidence on pain very uncertain. The 2017 ACCURATE trial (152 patients, lower-extremity CRPS or causalgia) reported treatment success, at least 50 percent pain reduction without stimulation-related neurologic deficit, in 81.2 percent with dorsal root ganglion stimulation against 55.7 percent with traditional spinal cord stimulation at three months.

A February 2026 systematic review of bisphosphonates (11 trials, 754 participants, 97 percent Type I) found low-certainty evidence of little or no immediate-term difference, a possible short-term reduction of about 10 points on a 0 to 100 scale, little or no medium-term difference, very uncertain long-term evidence, and probably more adverse events. Physical therapy and desensitization are standard care. An August 2026 review of intravenous ketamine (21 studies, 605 patients) found a pooled mean reduction of 3.6 points on a 10-point scale at the earliest assessment within 14 days, in studies mostly at moderate to high risk of bias, waning toward baseline through 90 days.

If a sympathetic block did not help you, that is sometimes offered as proof the diagnosis is wrong, and it says very little about whether you have CRPS. No head-to-head comparisons of these blocks exist, and the 2023 Cochrane overview called placebo-controlled lidocaine sympathetic blockade moderate-certainty evidence of probably no benefit for pain.

What Michigan Law Asks You to Prove

The no-fault threshold. To recover for pain and suffering, you must clear the serious impairment threshold. MCL 500.3135(5) asks for an impairment that is objectively manifested, meaning observable or perceivable from actual symptoms or conditions by someone other than you; that impairs an important body function; and that affects your general ability to lead a normal life. What counts is how the injury affected your bodily functions, not its label (McCormick v Carrier, 487 Mich 180 (2010)).

“Objectively manifested” is where these cases are contested, and it is where Criterion C works for you: Criterion C calls for signs a doctor observes rather than symptoms you report.

Qualification requirements for a PIP examiner. If your benefits were cut off after an insurance exam, that doctor’s credentials are worth checking. MCL 500.3151 reaches a narrow category: subsection (1) applies where your mental or physical condition is material to a claim for past or future personal protection insurance benefits. It is not a general rule for defense medical exams; one in ordinary civil litigation falls under MCR 2.311.

Subsection (2) requires that where a specialist provides your care, the examining physician specialize in the same specialty, be board certified in it if your treating physician is, and have devoted a majority of professional time in the preceding year to active clinical practice in that specialty or to instructing in an accredited medical school, residency or clinical research program in it.

That turns on the doctor’s actual practice, not the label, and Michigan has fixed no specialty matchup. MCL 500.3153 lets the court enter just orders for noncompliance with sections 3151 and 3152, including exclusion where a physician fails to furnish the report section 3152 requires. No published Michigan appellate decision makes such a report automatically void, so this is a ground to challenge it, not a way to erase it. See our page on insurance medical exams and benefit cutoffs.

Expert admissibility. Before your doctor can testify, a judge decides whether the method is reliable. Michigan applies MCL 600.2955 alongside MRE 702, amended effective May 1, 2024, which now requires the proponent to show each admissibility requirement is more likely than not met, including that the expert’s principles and methods were reliably applied to the facts. The statute separately lists seven factors, among them testing and replication, peer review publication, known or potential error rate, general acceptance, and whether the methodology is relied upon outside of litigation.

That last factor helps you: the Budapest Criteria are used in ordinary clinical practice, not invented for court. Peer-reviewed literature is neither always necessary nor always sufficient, and courts must weigh all the reliability factors rather than rest on one (Elher v. Misra, 499 Mich. 11 (2016)). A lack of supporting published literature cannot by itself establish inadmissibility, and the trial court must apply MRE 702 and the MCL 600.2955 factors (Danhoff v Fahim (Mich, 2024)).

Your account of the pain will not carry the threshold alone: subjective complaints do not establish an objectively manifested impairment without evidence of a physical basis, and medical testimony is generally, though not invariably, required (Patrick v Turkelson, 322 Mich App 595 (2018)).

Workers’ compensation. If this happened at work, nothing in the act excludes pain syndromes. MCL 418.301(1) requires a personal injury arising out of and in the course of employment, with work causing, contributing to or aggravating pathology in a manner that creates pathology medically distinguishable from what existed before. Your claim is not a mental-disability claim merely because it has a psychiatric component. Where subsection (2) applies, it requires a mental disability arising from actual events of employment rather than unfounded perceptions, your perception reasonably grounded in fact or reality, and employment events that contributed to, aggravated, or accelerated it in a significant manner. Those are the elements, the Martin factors are not an exclusive test, and the significant-manner question is decided on the totality of the circumstances (Cramer v Transitional Health Services of Wayne (Mich, July 28, 2023)).

What Helps Your Case Most

Keep every appointment; gaps in treatment become an issue on causation and severity. Ask your physician to record the observed signs at each visit, not only the pain score: temperature difference, color, swelling, sweating, range of motion, hair and nail changes. Photograph the limb regularly, in consistent light, beside the unaffected one. Keep a short daily record of what you could not do, and tell your doctors the truth, including on better days.

Why Choose Vahdat Weisman Law?

From our Livonia office, we represent injured people throughout Michigan. Founding partners Kara E. Weisman and Jordan S. Vahdat have each been honored as Super Lawyers Rising Stars. Our attorneys are members of the State Bar of Michigan and active in the Michigan Association for Justice. We advance case costs, we work in English and Spanish, and we are available 24/7.

Frequently Asked Questions

• The insurance doctor says CRPS is not real and that I am exaggerating. Is that right? CRPS is a recognized condition with published international diagnostic criteria and its own categorization in ICD-11, and Criterion A treats pain out of proportion to the injury as part of the definition. If that exam was for a personal protection insurance benefits claim, whether the examiner met the requirements in MCL 500.3151(2) is a separate question worth asking.
• My MRI and nerve tests came back normal. Does that hurt my case? CRPS is diagnosed clinically, and the corroborating tests are not strong enough either way to settle it. Under Patrick v Turkelson your record still has to show a physical basis for the impairment, and the signs your doctor observes and records supply it.
• What is a case like mine worth? That depends on your medical evidence, your documented limits, the effect on your earnings, and the future care a physician says you will need. Our page on life care plans and future medical costs explains how we prove that.

About the Author

Jordan S. Vahdat is a founding partner of Vahdat Weisman Law in Livonia and handles negligence, premises liability, auto accident, and insurance dispute cases. He has been admitted in all Michigan state courts since 2014, practices in the Eastern District of Michigan, and has served as a case evaluator for the Washtenaw Circuit Trial Court and the 15th District Court since 2020. He is fluent in Spanish.

Talk to a Michigan CRPS Lawyer

If you have been diagnosed with CRPS, RSD, or a serious nerve injury, call Vahdat Weisman Law at (734) 469-4994 or contact us online for a free consultation. Available 24/7, serving all of Michigan, with Spanish-speaking staff.

Dedicated to Justice. Devoted to You. Winning for Your Future.

Reviewed by Jordan S. Vahdat, Vahdat Weisman Law. Last reviewed September 2026.

This information is for educational purposes only and does not constitute legal advice. Every case is unique, and prior results do not guarantee future success.